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HEALTH CONDITIONS
LOW EJECTION FRACTION (EF)
What is it?
Ejection fraction (EF) is a measure of the
amount of blood pumped out of the left ventricle
(one of the two lower chambers of the heart).
The term "ejection fraction" is used because it is
a measurement of the blood pumped or
"ejected" with each heartbeat. Because not all of
the blood is ever completely pumped out of the
ventricle, this number gives you the "fraction" of
the total amount of blood pumped out.
Your EF, which is given as a percentage, reveals
how well your left ventricle is working. In a
sense, it reveals how healthy or unhealthy your
heart muscle is. A normal EF is 50% or more—
meaning at least 50% of the blood is pumped out
of your left ventricle with each heartbeat. Generally a value of less than 40% is
considered low. But no single percentage determines a low EF. Your doctor
decides what is low for you by looking at your overall health and risk factors.
Other names for a low ejection fraction: low EF, low left ventricular ejection
fraction (low LVEF).
What is the cause?
A low ejection fraction (EF) is caused by some type of damage to the heart
muscle. Some things that damage the heart muscle include:
• Heart attack
• Heart failure
• Heart muscle disease (cardiomyopathy)
• Heart valve disease
Managing your risk factors is key to preventing a heart attack, heart failure, and
other problems. In particular, the risk factors you can control often make a major
difference in your heart's health. To learn more, go to the Risk Factors section.
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What are the symptoms?
Sometimes you can have a low ejection fraction (EF) and yet have no symptoms.
Many people with a low EF also have heart failure. So the symptoms of a low EF
might actually be heart failure symptoms:
• Shortness of breath—this may get worse when you lie down.
• Fatigue—this happens because your muscles aren't getting enough oxygen
from your blood.
• Chronic cough—this is due to fluid buildup in the lungs.
• Fluid retention—this happens especially in the legs and feet.
In other cases a person might notice symptoms of dyssynchrony when they have
a low EF:
• A heart murmur (due to valve disease)
• Fast, abnormal heartbeats called arrhythmias
• Swollen neck veins
What tests could I have?
To find out if you have a low ejection fraction (EF), your doctor may suggest one
or more of the tests listed below. The test results can also help your doctor
choose the best treatment(s) for you.
In some cases you may be sent to specialists for diagnosis and testing—and
sometimes for treatment. To learn more, go to the Your Treatment Team section.
Chest X-ray
CT Scan
Echocardiogram
MRI
Chest X-ray
What is a chest x-ray?
A chest x-ray produces an image of your heart, lungs, and nearby blood vessels.
It reveals the:
• Size and shape of your heart
• Presence of fluid around your lungs
• Position and shape of your large arteries
An x-ray can help diagnose many different conditions, including heart diseases.
And if you have a cardiac device like a pacemaker, the x-ray also shows the
device and the coated wires (leads) that carry the energy to your heart.
What can I expect?
When you have a chest x-ray you undress from the waist up and put on a
hospital gown. You are partly covered by a shield—a heavy apron made of
flexible lead—to protect you from any excess radiation. (X-rays use only a small
amount of radiation to create the image.) You stand in front of the x-ray machine
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and hold your breath while the image is taken. Your doctor usually orders two
views: one from the back and one from the side.
What are the treatment options?
A low ejection fraction is caused by damage to your heart, like that from a heart
attack. So part of your treatment may include living a healthier lifestyle to avoid
further damage to your heart muscle. For example, if you tend to eat high-fat
foods, your doctor or nurse can suggest some ways to help you eat healthier
foods. Or they might refer you to a dietitian. To learn more, go to the Risk Factors
section.
Other types of treatment depend on your test results. Your doctor may
recommend one or more of these medications or procedures.
Computed Tomography (CT or CAT) Scan
What is a CAT scan?
A computerized (or computed) tomography (CAT, or CT) scan is a special type of
x-ray. Although a CAT scan is used to get images of many parts of the body, let's
use the example of the heart. A traditional x-ray shows two-dimensional images
of the heart—its length and width. But a CAT scan uses an x-ray machine that
moves around your body and takes multiple images of the heart. As small
amounts of x-rays pass through your body, different types of tissue absorb
different amounts of the x-rays. This helps provide a more precise image
compared to a traditional x-ray.
The CAT scan images are viewed together on a video monitor, offering a threedimensional view—length, width, and depth. Because it is a three-dimensional
image, a CAT scan offers a much better picture of the entire heart than a
traditional two-dimensional x-ray can.
A CAT scan is used to detect many health conditions—tumors, for example, or
bone problems like osteoporosis. As it relates to heart and blood vessel disease,
a CAT scan is often used to identify:
Some types of heart disease, such as heart failure
A blood vessel blockage or blood clot
What can I expect?
When you have a computed tomography (CAT) scan, you typically undress and
put on a hospital gown or sheet. You lie on an exam table. As the test begins, the
table slowly moves inside a doughnut-shaped machine.
Sometimes you receive a contrast dye—usually through an intravenous (IV) line
that is put into your arm. The dye allows your heart or blood vessels to show up
as images on a monitor. For instance, if the test is being done to look at your
blood vessels, the dye makes them visible—almost like roads on a map. You
might notice some effects from the dye:
• Warm flushing feeling, and maybe nausea, for a minute or so
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•
Metallic taste when the dye reaches the blood vessels in your mouth
The technician asks you to hold your body still during the scan. Sometimes
pillows and/or straps help you stay in the same position. As the x-ray tube rotates
around your body, the table slowly moves through the machine. You might be
asked to hold your breath at certain times during the scan. Although the CAT
scan is generally not a painful test, you may feel uncomfortable from having to lie
in one position during the test—anywhere from 15 to 60 minutes.
Echocardiogram
What is an echocardiogram?
An echocardiogram (also called an echo) is a three-dimensional, moving image
of your heart. An echo uses Doppler ultrasound technology. It is similar to the
ultrasound test done on pregnant women. The echo machine emits sound waves
at a frequency that people can't hear. The waves pass over the chest and
through the heart. The waves reflect or "echo" off the heart, showing:
• The shape and size of your heart
• How well the heart valves are working
• How well the heart chambers are contracting
• The ejection fraction (EF), or how much blood your heart pumps with each
beat
What can I expect?
When you have an echocardiogram, you undress from the waist up, put on a
hospital gown, and lie on an exam table. The technician spreads gel on your
chest and side to help transmit the sound waves. The technician then moves a
pen-like instrument (called a transducer) around on your chest or side. The
transducer records the echoes of the sound waves. At the same time, a moving
picture of your heart is shown on a special monitor. You may be asked to lie on
your back or your side during different parts of the test. You may also be asked
to hold your breath briefly so that the technician can get a good image of your
heart. An echo is a painless test. You feel only light pressure on your skin as the
transducer moves back and forth.
Magnetic Resonance Imaging (MRI)
What is magnetic resonance imaging (MRI)?
Magnetic resonance imaging (MRI) uses magnets, radio waves, and computer
technology to create images of different parts of your body. MRI is especially
useful in creating clear images of soft tissues. For instance, many people have
an MRI to check their heart and/or blood vessels.
MRI is done in a large, tube-shaped machine. Coils inside the machine's walls
produce a strong magnetic field. Other coils inside the machine's walls send and
receive radio waves. In response to the radio waves, your body produces faint
signals. As the machine senses the faint signals, a computer creates threedimensional images of the inside of your body.
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The images can reveal:
• Blockages in blood vessels
• The size and thickness of your heart's chambers
• Damaged muscle from a heart attack
• How your heart valves are working
What can I expect?
Before your magnetic resonance imaging (MRI) you undress and put on a
hospital gown or sheet. Before entering the MRI room, it's important to remove
any jewelry, hearing aids, or anything else with metal in it. The magnets in the
MRI machine are very strong, and if you have metal on your body you could
possibly be injured. Most people with a cardiac device—a pacemaker,
implantable defibrillator, or heart failure device—should typically avoid an MRI.
All cardiac device patients should check with their doctor before scheduling an
MRI.
Once in the MRI room, you lie on a moveable table and an intravenous (IV) line
is put into your arm. The IV delivers fluids and medications during the procedure.
For instance, the technician may put contrast dye into the IV.
Patches called electrodes are put on your chest. The electrodes connect to wires
on an electrocardiogram (ECG). The electrodes and ECG monitor your heart's
activity during the procedure. Often a blood pressure cuff on your arm also
regularly takes your blood pressure. The table you are lying on slides into the
MRI scanner, but there are no moving parts inside the machine. You wear
headphones or earplugs to muffle some of the noises from the machine, which
makes thumping sounds. The technician might ask you to lie very still or hold
your breath for parts of the test. However, you may feel muscles twitching in your
fingers or toes.
Medications
ACE Inhibitors
Beta Blockers
Diuretics
Inotropes
Vasodilators
Procedures
Defibrillator Implant
Heart Failure Device Implant
Heart Transplant
MEDICATIONS
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Tips for Taking Heart Medications
If you have a heart or blood vessel condition, you might want to know more about
some of the medications you take. The information in this section describes
some medications commonly prescribed for heart or blood vessel conditions. It
also includes some tips to help you take your medications as ordered.
Make sure you tell your doctor—or any new doctor who prescribes medication for
you—about all the medications and dietary supplements you take. Your doctor
can then help make sure you get the most benefit from your medications. Telling
your doctor this information also helps avoid harmful interactions between
medications and supplements.
You may also want to discuss these topics with your doctor or nurse each time
you get a new medication:
• The reason you're taking the medication, its expected benefits, and its
possible side effects
• How and when to take your medications
• If you take other medicines, vitamins, supplements, or other over-the-counter
products
In some cases, your heart needs several months to adjust to new medications.
So you may not notice any improvement right away. It also may take time for
your doctor to determine the correct dosage.
Blood tests are sometimes necessary for people who take heart medications.
The blood tests help your doctor determine the correct dosage—and therefore
help avoid harmful side effects.
Never stop taking your medication or change the dosage on your own because
you don't believe you need it anymore, don't think it's working properly, or feel
fine without it.
Be sure to talk to your doctor or nurse if you have:
• Questions about how your medications work
• Unpleasant side effects
• Trouble remembering to take your pills
• Trouble paying for your medications
• Other factors that prevent you from taking your medications as needed
• Questions about taking any of your medications
And don't hesitate to ask your pharmacist if you have questions about how and
when to take your medications.
ACE Inhibitors
“ACE” is short for “angiotensin-converting enzyme." ACE inhibitors are
medications that help prevent your body from producing too much of a natural
chemical called angiotensin II.
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Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)
moexipril (Univasc)
perindopril erbumine (Aceon)
quinapril (Accupril)
ramipril (Altace)
trandolapril (Mavik)
What they're used for
To treat high blood pressure
To treat heart failure and related conditions, such as low ejection fraction (EF)
To reduce damage after a heart attack and to help reduce the chance for further
heart attacks
How they work
ACE inhibitors block an enzyme that is needed to produce angiotensin II. The
body uses angiotensin II to maintain proper blood pressure and fluid balance. But
angiotensin II can have harmful long-term effects on your heart and blood
vessels. It can cause blood vessels to narrow and can also raise blood pressure.
Taking ACE inhibitors can:
Relax the arteries
Lower blood pressure
Help the heart work more effectively
Beta Blockers
Beta blockers get their name because they "block" the effects of substances like
adrenaline on your body's "beta receptors."
Some generic (and brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
acebutolol (Sectral)
atenolol (Tenormin)
betaxolol (Kerlone)
bisoprolol (Zebeta)
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carvedilol (Coreg)
labetalol (Trandate)
metoprolol (Lopressor, Toprol)
nadolol (Corgard)
penbutolol (Levatol)
pindolol (Visken)
propranolol (Inderal)
sotalol (Betapace, Sorine)
timolol (Blocadren)
What they're used for
To treat high blood pressure
To slow fast arrhythmias (abnormal heartbeats, or heart rhythms)
To prevent angina (chest pain due to blocked blood flow to parts of the heart)
To prevent long-term damage after a heart attack
To treat heart failure and related conditions, such as low ejection fraction (EF)
How they work
These medications block activity of your sympathetic nervous system. The
sympathetic nervous system reacts when you are stressed or when you have
certain health conditions. When your system responds, your heart beats faster
and with more force. Your blood pressure also goes up.
Beta blockers block signals from the sympathetic nervous system. This slows
your heart rate and keeps your blood vessels from narrowing. These two actions
can result in:
Lower heart rate
Lower blood pressure
Less angina (chest pain related to the heart)
Fewer arrhythmias (abnormal heartbeats, or heart rhythms)
Diuretics (Water Pills)
Diuretics remove excess water from your body.
Some generic (and brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
amiloride (Midamor)
bendroflumethiazide (Naturetin)
bumetanide (Bumex)
chlorothiazide (Diuril)
chlorthalidone (Hygroton, Thalitone)
eplerenone (Inspra)
ethacrynic acid (Edecrin)
furosemide (Lasix)
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hydrochlorothiazide (Microzide, Oretic)
indapamide (Lozol)
methyclothiazide (Enduron)
metolazone (Zaroxolyn)
polythiazide (Renese)
spironolactone (Aldactone)
torsemide (Demadex)
triamterene (Dyrenium)
What they're used for
To lower blood pressure
To reduce edema (swelling caused by excess fluid in your body—often in the
legs and feet) associated with conditions such as heart failure
How they work
Some diuretics work by causing the kidneys to release more sodium (salt) into
urine. Sodium helps draw water out of the blood. With less fluid in your blood,
your blood pressure decreases.
Diuretics also relieve symptoms like shortness of breath. That's because excess
fluid in your lungs can cause these symptoms.
Inotropes
The word "inotrope" refers to the strength of the heart muscle's pumping action,
or contractions.
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
digoxin (Digitek, Lanoxicaps, Lanoxin)
What they're used for
To improve symptoms of heart failure and related conditions, such as low
ejection fraction (EF)
To slow the heart rate in response to atrial fibrillation (fast rhythm in the heart's
upper chambers)
How they work
The term "inotrope" describes the strength and force of the heartbeat. Taking
inotropic medications can:
Make the heart beat more strongly and efficiently
Help slow and control the heart rate for certain arrhythmias
Vasodilators
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One purpose of vasodilators is to lower blood pressure. To understand how
vasodilators work, imagine the same amount of water moving through a 1-inch
diameter hose versus a 2-inch diameter hose. The bigger the hose, the less
pressure on the walls of the hose.
Medications such as vasodilators can help relax and dilate blood vessels that
have become narrowed (constricted).
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
doxazosin (Cardura)
guanabenz (Wytensin)
guanfacine (Tenex)
hydralazine (Apresoline)
isosorbide dinitrate (Dilatrate, Isordil, Isochon)
isosorbide mononitrate (Imdur, ISMO, Monoket)
methyldopa (Aldomet)
minoxidil (Loniten)
nitroglycerin (Minitran, Nitro-Bid, Nitro-Dur, Nitrogard, Nitrolingual, NitroQuick,
Nitrostat)
prazosin (Minipress)
reserpine (Serpalan)
terazosin (Hytrin)
You may have heard of other types of vasodilators. Beta blockers, which are a
common heart and blood vessel medication, are one type of vasodilator. Another
type is calcium channel blockers.
What they're used for
To treat high blood pressure
To treat/prevent angina (chest pain related to the heart) which can result from
atherosclerosis (blocked blood vessels) and coronary artery disease (CAD)
How they work
Vasodilators help relax and dilate the blood vessels, so blood moves through
them more easily. This helps to:
Lower blood pressure
Allow the heart to work with less effort
Decrease the amount of angina (chest pain)
PROCEDURES
Defibrillator Implant (ICD Device Implant)
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What is a defibrillator (ICD device)?
An implantable cardioverter defibrillator (ICD) is a small device that treats
abnormal heart rhythms called arrhythmias. Specifically, an ICD treats fast
arrhythmias in the heart's lower chambers (ventricles). Two such arrhythmias are
ventricular tachycardia (VT) and ventricular fibrillation (VF).
Arrhythmias result from a problem in your heart's electrical system. Normal
electrical signals follow a certain path through the heart. It is the movement of
these signals that causes your heart to contract. To learn more about your heart's
electrical system, go to the Heart & Blood Vessel Basics section.
During VT or VF, however, far too many signals are present in the ventricles. In
addition, the signals often do not travel down the proper pathways. The heart
tries to beat in response to the signals, but it cannot pump enough blood out to
your body. If you have either VT or VF, you are at high risk of sudden cardiac
arrest (SCA). If not treated immediately with defibrillation, SCA can result in
sudden cardiac death (SCD).
An ICD can treat VT and VF and restore your heart to a normal rhythm. So it
reduces your risk of SCD. The device can deliver several types of treatment:
• Anti-tachycardia pacing (ATP) delivers very small amounts of energy to your
heart—so small that you can't feel the treatment.
• Cardioversion is a low-energy shock that treats fast but regular arrhythmias.
• Defibrillation is a high-energy shock that treats fast and chaotic (irregular)
rhythms. Defibrillation is painful for an instant, but it can also save your life.
A device implant is a procedure that uses local numbing. General anesthesia is
usually not needed.
An implanted device needs to be checked regularly to review information that is
stored in the device and to monitor settings. These checks can happen in the
clinic or from the comfort of the patient’s home using remote monitoring.
Remote monitoring uses a small piece of equipment that can sit on a bedside
table to collect data from the cardiac device. Data is collected on a daily or
weekly basis depending upon how the system is programmed and the type of
device implanted. It sends information through a regular landline phone to a
secure website that only the patient’s healthcare support team can access. In
many cases, remote monitoring means that the patient needs to make fewer trips
to the doctor's office for device follow-up visits. Not all devices can be checked
using remote monitoring, and not all doctors use remote monitoring.
How is the implant procedure done?
An Implantable cardioverter defibrillator (ICD) system has two parts.
Device—the device is quite small and easily fits in the palm of your hand. It
contains small computerized parts that run on a battery.
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Leads—the leads are thin, insulated wires that connect the device to your heart.
The leads carry electrical signals back and forth between your heart and your
device.
Your doctor inserts the leads through a small incision, usually near your
collarbone. Your doctor gently steers the leads through your blood vessels and
into your heart. Your doctor can see where the leads are going by watching a
video screen with real-time, moving x-rays called fluoroscopy.
The doctor connects the leads to the device and tests to make sure both work
together to deliver treatment. Your doctor then places the device just under your
skin near your collarbone and stitches the incision closed.
What can I expect?
Usually you are told not to eat or drink anything for a number of hours before the
procedure. You undress and put on a hospital gown or sheet. Your procedure will
be performed in a ”cath lab." You lie on an exam table and an intravenous (IV)
line is put into your arm. The IV delivers fluids and medications during the
procedure. The medication makes you groggy, but not unconscious.
The doctor makes a small incision near your collarbone to insert the leads. The
area will be numbed so you shouldn't feel pain, but you may feel some pressure
as the leads are inserted. You may be sedated when the device is tested, since it
delivers a shock to your heart.
You may be in the hospital overnight, and there may be tenderness at the
incision site. Afterwards most people have a fairly quick recovery.
Heart Failure Device Implant (CRT Device Implant)
What is a heart failure device (CRT device)?
A heart failure device, also called a CRT device, treats certain types of heart
failure. When the heart's lower chambers (ventricles) pump or contract in an
uncoordinated way, it is called dyssynchrony. The CRT device treats
dyssynchrony. CRT stands for cardiac resynchronization therapy. It gets its name
because the device helps “resynchronize,” or re-coordinate, the pumping of the
ventricles.
A device implant is a procedure that uses local numbing. General anesthesia
usually is not needed.
There are two types of CRT devices:
• A CRT-P device is a special kind of pacemaker. A regular pacemaker sends
tiny amounts of energy to one side of the heart. This electrical treatment is
called pacing therapy. A CRT device delivers pacing to both ventricles—both
sides of the heart. This is why the CRT-P device is sometimes called a
biventricular pacemaker.
• A CRT-D device offers the same type of pacing therapy described as a CRT-
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P device. But it also has a built-in implantable cardioverter defibrillator (ICD).
In the CRT-D device, the ICD can treat dangerously fast abnormal heart rhythms
(arrhythmias). Fast arrhythmias, like ventricular tachycardia (VT) or ventricular
fibrillation (VF), put people at risk of sudden cardiac arrest (SCA). If not treated
immediately with defibrillation, SCA can result in sudden cardiac death (SCD).
And in people with heart failure, SCD occurs at 6-9 times the rate of the general
population.
Many people benefit from a CRT device because it helps relieve symptoms of
heart failure. However, the device is not effective for everyone with heart failure.
An implanted device needs to be checked regularly to review information that is
stored in the device and to monitor settings. These checks can happen in the
clinic or from the comfort of the patient’s home using remote monitoring.
Remote monitoring uses a small piece of equipment that can sit on a bedside
table to collect data from the cardiac device. Data is collected on a daily or
weekly basis depending upon how the system is programmed and the type of
device implanted. It sends information through a a standard analog phone line to
a secure website that only the patient’s healthcare support team can access. In
many cases, remote monitoring means that the patient needs to make fewer trips
to the doctor's office for device follow-up visits. Not all devices can be checked
using remote monitoring.
How is the implant procedure done?
A CRT-P or CRT-D system has two parts.
Device—the device is quite small and easily fits in the palm of your hand. It
contains small computerized parts that run on a battery.
Leads—the leads are thin, insulated wires that connect the device to your heart.
The leads carry electrical signals back and forth between your heart and your
device.
Your doctor inserts the leads through a small incision, usually near your
collarbone. Your doctor gently steers the leads through your blood vessels and
into your heart. Your doctor can see where the leads are going by watching a
video screen with real-time, moving x-rays called fluoroscopy.
The doctor connects the leads to the device and tests to make sure both work
together to deliver treatment. Your doctor then places the device just under the
skin near your collarbone and stitches the incision closed.
What can I expect?
Usually you are told not to eat or drink anything for a number of hours before the
procedure. You undress and put on a hospital gown or sheet. Your procedure will
be performed in a ”cath lab." You lie on an exam table and an intravenous (IV)
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line is put into your arm. The IV delivers fluids and medications during the
procedure. The medication makes you groggy, but not unconscious.
The doctor makes a small incision near your collarbone to insert the leads. The
area will be numbed so you shouldn't feel pain, but you may feel some pressure
as the leads are inserted. If you have a CRT-D device implant, you may be
sedated when the device is tested, since it delivers a shock to your heart. Most
people do not need to be sedated if they have a CRT-P device implanted.
You may be in the hospital overnight, and there may be tenderness at the
incision site. Most people have a fairly quick recovery.
Heart Transplant
What is a heart transplant?
A heart transplant is the surgical replacement of a diseased heart with a healthy
heart from a donor. A heart transplant can prolong the life of a person with lifethreatening heart disease. Heart transplants are typically done in people who
have advanced heart failure that can’t be successfully treated with other
procedures or medications.
The transplant involves transferring a healthy heart from a donor to the recipient.
The donor is usually someone who has suffered brain death but whose heart is
healthy. The donor must be a similar height and weight as the recipient, and the
two must have the same blood type. However, the age, sex, and race of the two
individuals can differ.
A transplant must take place within 4 hours of the time the healthy heart is
removed from the donor. That’s why time—and location of the donor and
recipient—are such critical factors. People on the transplant waiting list usually
carry a pager at all times. They must be at the hospital shortly after being paged.
A heart transplant is a major surgery that involves general anesthesia and a fairly
long recovery period. In the United States, just over 2200 heart transplants are
done every year. Doctors could save many more lives if more people were willing
to be donors.
Left ventricular assist device (LVAD)
Sometimes a person has a surgery before the heart transplant. This initial
surgery is the implantation of a device called a left ventricular assist device
(LVAD). The LVAD is necessary because the left ventricle (lower heart chamber)
can become very weak from damage to the heart muscle. In some people the
weakened heart is increasingly unable to pump enough blood out to the body.
A LVAD helps by taking over the work of the left ventricle. A tube on the LVAD
takes blood entering the left ventricle and sends it to the LVAD pump. The LVAD
uses the right amount of force to pump the blood in a blood vessel, which then
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sends blood throughout the body. The LVAD is removed during the heart
transplant surgery.
An LVAD is most often used for people who are on a waiting list for a heart
transplant. So an LVAD is called a “bridge to transplant”. Until a heart is available
for the person on the list, the LVAD can help keep the heart working properly.
How is the surgery done?
Your heart transplant surgery begins with an incision in the breastbone
(sternum). Your doctor needs to operate on a completely still heart. So you
receive medications to stop your heart. A heart-lung machine then does the job
of both the heart and the lungs:
• It adds oxygen to your blood—as your lungs would do
• It pumps the blood back into, and throughout, your body—as your heart would
do
The doctor then removes your diseased heart and attaches the donor heart to
your blood vessels.
What can I expect?
Usually you are told not to eat or drink anything for a number of hours before
your surgery. You lie on an exam table and an intravenous (IV) line is put into
your arm. The IV delivers fluids and medications during the surgery. You are then
wheeled into the operating room, where you receive medication that makes you
unconscious during the surgery. After surgery you will be in the intensive care
unit (ICU) for several days. You stay in the hospital a total of about 2 weeks.
People often have pain at the incision site for several weeks, but medication is
provided for pain. At home, recovery usually takes another several months.
Heart transplants are associated with major risks, including infection and organ
rejection. After the transplant, you'll need to take many medications to stop your
body from "rejecting" the new heart. Your immune system will likely never get
used to the new organ. So you usually need to take some anti-rejection
medications for the rest of your life.
Low Ejection Fraction (EF)
HEARTISTRY brought to you by Boston Scientific Corporation
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Important Safety Information
Medications, procedures and tests can have some risks and possible side effects. Results may vary
from patient to patient. This information is not meant to replace advice from your doctor. Be sure to
talk to your doctor about these risks and possible side effects.
Cardiac resynchronization therapy pacemakers (CRT-P) and defibrillators (CRT-D) are used to treat
heart failure patients who have symptoms despite the best available drug therapy. These patients also
have an electrical condition in which the lower chambers of the heart contract in an uncoordinated way
and a mechanical condition in which the heart pumps less blood than normal. CRT-Ps and CRT-Ds
are not for everyone including people with separate implantable cardioverter-defibrillators (CRT-P
only) or certain steroid allergies. Procedure risks include infection, tissue damage, and kidney failure.
In some cases, the device may be unable to respond to your heart rhythm (CRT-P only) or may be
unable to respond to irregular heartbeats or may deliver inappropriate shocks (CRT-D only). In rare
cases severe complications or device failure can occur. Electrical or magnetic fields can affect the
device. Only your doctor knows what is right for you.
Boston Scientific is a trademark and HEARTISTRY is a service mark of Boston Scientific Corporation.
All other brand names mentioned are used for identification purposes only and are trademarks of their respective owners.
Low Ejection Fraction (EF)
HEARTISTRY brought to you by Boston Scientific Corporation
Page 16 of 16